Minowa Y, Sasai K, Ishigaki T, Nagata Y, Hiraoka M
Department of Radiology, Faculty of Medicine, Kyoto University.
Nihon Igaku Hoshasen Gakkai Zasshi. 1996 Dec;56(14):1056-60.
Radiation therapy is a useful palliative modality for refractory lesions of multiple myeloma. It has been reported that total doses of 10 to 20 Gy are usually adequate to obtain some degree of pain relief. However, there are many patients who need additional doses to obtain sufficient pain relief. In this study, we retrospectively analyzed the records of patients with multiple myeloma irradiated at our department, in an attempt to develop an effective treatment policy for this disease.
Twenty-nine patients with 53 lesions were treated between 1968 and 1993. Total irradiation doses were 4 to 60 Gy(median 40 Gy) with daily fractions of 2 Gy or less, and 16 to 51 Gy(median 30 Gy) with daily fractions greater than 2 Gy. Evaluated were 59 symptoms, including pain (68%), neurological abnormalities (15%), and masses (28%).
Symptomatic remission was obtained in 33 of 36 (92%) lesions with pain, 6 of 8(75%) with neurological abnormalities, and 13 of 15(87%) mass lesions. Pain was partially relieved at a median TDF of 34, and completely at a median TDF of 66(equivalent to 40-42 Gy with daily fractions of 2 Gy).
Radiation therapy is an effective and palliative treatment method for symptomatic multiple myeloma. However, the treatment seems to require higher radiation doses than those reported to obtain adequate relief of symptoms.
放射治疗是多发性骨髓瘤难治性病灶的一种有效姑息治疗方式。据报道，10至20 Gy的总剂量通常足以获得一定程度的疼痛缓解。然而，有许多患者需要额外剂量才能获得足够的疼痛缓解。在本研究中，我们回顾性分析了在我院接受放疗的多发性骨髓瘤患者的记录，试图制定针对该疾病的有效治疗策略。
1968年至1993年间，对29例患者的53个病灶进行了治疗。总照射剂量为4至60 Gy（中位数40 Gy），每日分次剂量为2 Gy或更低，以及16至51 Gy（中位数30 Gy），每日分次剂量大于2 Gy。评估了59种症状，包括疼痛（68%）、神经异常（15%）和肿块（28%）。
36个疼痛病灶中有33个（92%）、8个神经异常病灶中有6个（75%）、15个肿块病灶中有13个（87%）获得了症状缓解。疼痛在中位总剂量因子（TDF）为34时部分缓解，在中位TDF为66时完全缓解（相当于每日分次剂量2 Gy时的40 - 42 Gy）。
放射治疗是有症状的多发性骨髓瘤的一种有效姑息治疗方法。然而，该治疗似乎需要比报道的获得充分症状缓解所需剂量更高的放射剂量。
